A 38-year-old woman with primary adrenal insufficiency recei…

A 38-year-old woman with primary adrenal insufficiency receives oral hydrocortisone 20 mg in the morning and 10 mg in the afternoon. Despite adherence, she reports insomnia, weight gain and increased appetite. Her afternoon hydrocortisone dose is taken at 20:00. Which pharmacological intervention is most appropriate?

A 52-year-old woman presents to the clinic with back pain an…

A 52-year-old woman presents to the clinic with back pain and a recent wrist fracture after a minor fall. She has a history of prolonged elevated cortisol levels due to Cushing syndrome. Bone density testing confirms osteoporosis. Which cellular effect of excess cortisol best explains her osteoporosis?